Modeling Differential Rates of Increase of Serial PSA in African Americans and Caucasians Following Radical Prostatectomy

摘要

Prostate cancer is currently the most common malignant neoplasm and the second leading cause of cancer-specific death among males in the United States. African American men (AAM) have higher incidence and mortality from prostate cancer than Caucasian men (CM) Outcome data of men treated with radical prostatectomy for clinically localized prostate cancer also demonstrate more advanced tumors at diagnosis, and for each pathologic stage, AAM have higher recurrence rates than CM. Given the differential disease outcome in the two races, it is conceivable that race may have an effect on the rate of progression in patients that experience biochemical recurrence following surgery. The proposed study models follow-up prostate specific antigen (PSA) measurements to characterize the pattern of progression in patients who suffer biochemical recurrence. Relative rates of progression are also derived for AAM and CM. Based on longitudinal data analysis, the current study did not find any statistically significant difference in the post-surgery relative rates of progression between the two races. Results from this research does not warrant the need for earlier therapeutic intervention in AAM compared to CM who demonstrate signs of rising PSA following radical prostatectomy for clinically localized prostate cancer.